Date of Submission


Degree Type


Degree Name

Doctor of Psychology (PsyD)



Department Chair

Robert A DiTomasso, PhD, ABPP, Chair, Department of Psychology

First Advisor

Donald P Masey, PsyD, Chairperson

Second Advisor

Robert A DiTomasso, PhD, ABPP

Third Advisor

Brian J Balin, PhD


Concussion is an increasingly diagnosed injury that affects individuals of all ages. Although the underlying cause is unknown, research has demonstrated that females who sustain a concussion experience longer recoveries. Existing research has documented a relationship between age, gender, post-concussive headache and mental health conditions, and recovery; however, limited research has investigated the relationship between premorbid clinical variables and recovery. Research on post-injury neurocognitive declines and recovery has also demonstrated varied findings. Moreover, dizziness has been identified as significantly predictive of prolonged recovery, but no studies have investigated the effect of premorbid headache conditions on the development of dizziness. The goals of this study were to determine whether ( 1) premorbid mental health conditions and/or premorbid headaches and post-concussive neurocognitive patterns of decline would predict longer recovery from concussion; (2) premorbid headaches would predict post-concussive dizziness; and (3) mental health conditions would predict post-injury affective symptoms in a group of females from a specialized outpatient concussion treatment facility (N=180). Results indicated that delay in initial post-injury evaluation was most predictive of a prolonged recovery and that premorbid mental health conditions positively predicted post-injury psychiatric symptoms. These direct positive relationships existed while controlling for age at injury, prior history of concussion, and mechanism of injury. This is one of the few studies to investigate the relationship between premorbid mental health conditions and recovery, and the only study to investigate the relationship between premorbid headache conditions and (1) post-concussive dizziness and (2) prolonged recovery.